October 25, 2023 — In an opinion piece in Nature Human Behavior, Laura Kubzansky, professor of social and behavioral sciences and co-director of the JPB Environmental Health Fellowship Program at Harvard T.H. Chan School of Public Health, and her co-authors argued that prosociality is a critical, but underappreciated, factor affecting population health—and urged public health researchers and practitioners to invest more resources to better understand it.
Q: What is prosociality and how does it impact human health?
A: When we talk about prosociality we talk about the beliefs and behaviors of people who care about others and want to benefit others with their actions. Altruism, cooperation, compassion, empathy, and social capital—all of these are examples of prosocial behaviors and conditions.
Research has found that prosociality has positive health benefits. For example, scientists have looked at the relationship between volunteering, which is helping others with no apparent reward (or expectation of one), and mortality. They reliably find that people who volunteer more also tend to live longer lives. Other studies also found that during the COVID-19 pandemic people living in communities with higher levels of prosociality were also more willing to wear a mask or receive the vaccine, which are behaviors that we now know are associated with lower COVID-19 mortality rates. In fact, a recent Lancet Commission identified low levels of prosociality as a contributing factor to the numerous failures we saw during the pandemic around the world with regard to controlling deaths from this infectious disease. My co-authors—Richard Davidson at the University of Wisconsin-Madison and Elissa Epel at the University of California San Francisco—and I believe that the effects of prosociality go beyond mitigating effects of infectious diseases and that prosociality can improve both individual and community health much more broadly.
Q: You call for prosociality to become “a novel strategy for improving population health.” What do you mean by that?
A: We need to invest time and resources to better understand prosociality and its effect on population health. In public health, we try to identify factors that can improve the health and well-being of people. For example, we look at an unhealthy diet and ask ourselves, “Who is more likely to consume it and why? How can we improve it and what are the health consequences if we do so?”
We need to do the same with prosociality—try to better measure how much prosociality matters for population health. And if we find out that it does in fact matter, we should study the mechanisms through which prosociality improves health. We should look at ways to increase prosociality among the population. We should also monitor the downstream effects and look at the distribution of prosocial behaviors in the population. Are they more prevalent among certain groups of people? What conditions do we need to make it more prevalent? And do diverse populations benefit from prosociality equally or are certain people more likely to see health benefits when they engage in prosocial behaviors? Those are all questions we would like to be able to answer by conducting national surveys, adding measures of prosociality to major cohort studies, and running randomized trials.
Q: How could prosociality help improve public health?
A: When we talk about improving health, we often focus on clinicians caring for individuals who are already struggling with problems. The call for making prosociality a public health priority is an effort to focus on upstream factors that enable people to maintain better health for longer, and thereby reduce the need for clinicians over the long run. Risk factors are very important, but sometimes they are not enough. We need to also identify the health assets that can protect our physical and mental health.
In the U.S. we are facing an epidemic of deaths of despair and a mental health crisis. It is crucial that we try to minimize or eliminate risk factors such as poverty, family medical history, or smoking, which we know put certain individuals more at risk for deaths of despair and mental health struggles. At the same time, however, we must recognize we can do better and aspire to do more than solely reducing misery. We must also identify and promote factors that can help people attain and maintain health and prevent them from developing illness in the first place.
Improving population levels of prosociality could also be particularly relevant in the context of climate change and other major societal disruptions like civil unrest or war. Increasing levels of prosociality or our willingness to engage in actions that help others, either at the individual or the societal level, could be a game changer to reduce the impacts of large-scale societal events on our health.
During COVID-19, we saw a deficit of kindness and compassion. And we also saw the public health consequences of that. I would argue that understanding prosociality isn’t simply a nice-to-have luxury. It is a critical and underappreciated factor that deserves our full attention.
Illustration: iStock / Mykyta Dolmatov
*This story was updated to include the names of the co-authors.